The big picture in Intelligent VentilationThe big picture in Intelligent Ventilation

www.hamilton-medical.com/C3

1 Needham DM, Bronskill SE, Calinawan JR, Sibbald WJ, Pronovost PJ, Laupacis A. Crit Care Med 2005 Mar;333:574-9.

2 U.S. Census Bureau, Systems Support Division, Last Revised: July 14, 2009 3 Zilberberg M et al. BMC Health Services Research 2008;8:2424 Prospects: The 2008 Revision. Committee on Quality of Healthcare in America.

To Err is Human. Institute of Medicine, 1999. Angus D. JAMA 2000, Martin GS. CCM 2006, Poncet MC. AJRCCM 2007, Embriaco N. AJRCCM2007

5 http://patientsafety.esicm.org/declaration.asp6 Richard JC, Kacmarek RM. Intensive Care Med. 2009 Oct;35(10):1662-3.

More safety for your patient

The world’s population is growing. As people are getting older and sicker, the number of ventilated patients in the ICUincreases1,2. The estimated cost for intensive care and me-chanical ventilation is expected to increase from 16 billion USD in 2003 to 60 billion USD by 20203. The clinical impact will be signifi cant. An increased number of older patients will lead to more complex patient care, while ICUs will be facing a lack of specialized staff 4.

Get your ICU readyThe 2009 Vienna Declaration5 by the ESICM Executive Com-mittee stresses the importance of quality and safety for pa-tient care, especially when looking at future demographic changes. The declaration pledges to do what is necessary to provide safe ICU environments and to design safer and more effi cient devices and drugs.

HAMILTON MEDICAL has the answerHAMILTON MEDICAL has the answerHAMILTON MEDICALAs a manufacturer of ICU ventilators, we are committed tosupporting this declaration. To do so, we follow the exam-ple of other high-risk industries such as aviation and nuclear power in embracing automation and user interface design.6

The HAMILTON-C3 provides you with:– a 12.1 inch high-resolution widescreen display for more in-

formation at a glance– its unique Ventilation Cockpit that is designed to improve

safety through intuitive operation and monitoring– proven closed-loop ventilation that automatically applies

lung-protective strategies – reducing the risk of operator errors and promoting early weaning

– a single, versatile source of invasive and non-invasive ven-a single, versatile source of invasive and non-invasive ven-a single, versatile source of invasive and non-invasive ven-a single, versatile source of invasive and non-invasive ven-a single, versatile source of invasive and non-invasive ven-tilation for adults, pediatrics and neonatal tilation for adults, pediatrics and neonatal tilation for adults, pediatrics and neonatal tilation for adults, pediatrics and neonatal tilation for adults, pediatrics and neonatal ICUICUICUs, emer-s, emer-s, emer-gency and recovery rooms, subacute care, and intrafacility gency and recovery rooms, subacute care, and intrafacility transport

– integrated turbine and hot-swappable batteries providing maximum mobility for up to 6.5 hours

The HAMILTON-C3 was designed to provide Intelligent Ventilation, delivering:

Ease of useVisualizing complex information in an intuitive way

Improved patient outcomeFully closed-loop ventilation promotes early weaning

Efficiency through innovationReduce the patient’s time on the ventilator

www.hamilton-medical.com/C3

1 Vignaux L, Tassaux D, Jolliet P. Intensive Care Med. 2009 Oct;35(10):1687-912 Arnal JM, Durand-Gasselin J. Intensive Care Med. 2008 Jan;34(1):75-81. 3 Petter AH et al. Anesth Analg 2003;97:1743-50.4 Adaptive support ventilation (ASV) automatically adapts a protective ventila-

tion in ARDS patients. Arnal JM, Garcin F, Wysocki M, Corno G, Orlando A, Durand-Gasselin J. Intensive Care Med 2006:32 suppl 1: 0452

In mechanical ventilation, monitoring means curves, num-bers and more numbers. Conventional ventilation requires sig-nifi cant clinical expertise and numerous manual adjustments. This can be challenging and stressful since respiratory experts cannot be at the bedside all the time. Ventilators clearly need to be simpler to use so the clinician can concentrate on the patient, not the ventilator.

See and understand all important informationat a glanceOur Unique Ventilation Cockpit on the HAMILTON-C3 reduc-es complexity by visually displaying the patient’s respiratory mechanics, current condition and ventilation support in an in-tuitive way. The HAMILTON-C3 graphically displays this infor-mation on a single 12.1-inch high-resolution window, provid-ing you with a continuous ventilation therapy “big picture”.

Proven technology you can trustThe HAMILTON-C3 comes with ASV® – Adaptive Support Ven-tilation – technology which provides major improvements. Conventional modes require you to set numerous parameters. Closed-loop ventilation with ASV® adjusts ventilation settings automatically which reduces the risk of human error and im-proves patient safety. 1

Studies show that ASV®:– ventilates virtually all intubated patients – whether active or

passive – regardless of their lung disease2

– requires less user interaction, adapts to patient’s breathing activity more frequently, and causes fewer alarms3

– adapts to changes in the patient’s lung mechanics over timeadapts to changes in the patient’s lung mechanics over timeadapts to changes in the patient’s lung mechanics over time4

Ease of use

Simple ventilation settingSet your patient’s height and gender, choose your ventilation mode and start ventilation with the optimal setting for controls and alarm limits.

ASV adapts to lung mechanics by automatically applying lower tidal vol-umes in ARDS patients. The graph shows tidal volumes graph shows tidal volumes applied in ARDS patients over 7 days.46

77

8

9

Vt/

IBW

(m

l/kg

)V

t/IB

W (

ml/

kg)

AR

DS

No

rmal

CO

PD

Normal compliance and Normal compliance and resistance

Low compliance (stiff lung) Low compliance (stiff lung) and high resistance

Understand lung mechanicsThe Dynamic Lung expands and contracts in synchrony with actual breaths. It visualizes in real-time:– tidal volume – lung compliance– resistance– patient activity

www.hamilton-medical.com/C3

1 Preventing ventilator-related deaths and injuries. Jt Comm Perspect. 2002 Apr;22(4):14-5.

2 Vignaux L, Tassaux D, Jolliet P. Intensive Care Med. 2009 Okt;35(10):1687-913 Tassaux D, P, Jolliet P. Crit Care Med. 2002 Apr;30(4):801-7. 4 Arnal JM, Durand-Gasselin J. Intensive Care Med. 2008 Jan;34(1):75-81.5 Chen CW, Huang YC. Respir Care. 2011 Jul;56(7):976-83. 6 Jung B, Jaber S. Anesthesiology. 2010 Jun;112(6):1435-43. 7 Gruber et al., Anesthesiology. 2008; 109:81-7

Improved patient outcome and safetyImproved patient outcome and safety

In a root cause analysis of deaths or injuries related to long-term ventilation, the Joint Commission on Accreditation ofHealthcare Organizations (JCAHO) found that inadequatebriefi ng / training and failure to communicate between staff members were by far the most important causes.1 As a lead-ing manufacturer of ICU ventilators, transparent patient-cen-tered care is of key importance at HAMILTON MEDICAL when developing new devices.

Increased safety of operationThe Ventilation Cockpit’s 12.1-inch high-resolution wide-screen display plays a crucial role in simplifying the operation of the ventilator and the interpretation of monitored data. In addition, the specially designed alarm lamp at the top of the unit ensures that an alarming ventilator is immediately identifi ed, visually, in addition to audibly2.HAMILTON MEDICAL ventilators are designed to achieve op-timum patient compliance with the applied ventilation ther-apy. For example, reduced sounds and dimmable lights let the patient rest during the night. Optimal synchronization of breath delivery with patient efforts support early and weak patient activities. Monitoring and alarming are adapted to the challenges3 of non-invasive ventilation. The use of speak-ing-valves is possible, allowing the patient to communicate with the environment.

Lung protective strategies and patient comfortHAMILTON MEDICAL’s HAMILTON MEDICAL’s HAMILTON MEDICAL ASV® employs lung protective strategies to minimize complications from AutoPEEP and as a result,4

volutrauma/barotrauma. ASV also prevents apnea, tachypnea, excessive dead space ventilation, and excessively long breaths. breaths. breaths. ASVASVASV®®® promotes free breathing for patients in all ven- promotes free breathing for patients in all ven- promotes free breathing for patients in all ven-tilation modes and phases. It encourages spontaneous activ-tilation modes and phases. It encourages spontaneous activ-tilation modes and phases. It encourages spontaneous activ-tilation modes and phases. It encourages spontaneous activ-ity right from the start of ventilation and promotes weaning ity right from the start of ventilation and promotes weaning from fi rst deployment. 5, 6

IntelliTrigChanging breathing patterns or circuit leaks are a challenge in non-invasive ventilation. With the innovative IntelliTrig technology, the HAMILTON-C3 automatically responds to varying leaks and adapts sensitivity thresholds for optimal re-sponse to the patient’s breath.

Reduce time on the ventilator by over 50 %ASV facilitates shorter times on the ventilator: 6 hours with ASV as compared to 14 hours with conventional ventilation.7

Understand changes in the patient condition and how ASV reactsThe ASV Breathing Map shows how the adaptive lung controller is approach-ing its targets. It shows both the target and actual parameters for tidal volume, frequency, pressure, and minute ventilation.

0.0

0 2 4 6 8 10 12 14

0.2

0.4

0.6

0.8

1.0

6hrs

14h

rs

ASVControl

Time (hours)

Cu

mu

lati

ve r

ate

of

extu

bat

ion

www.hamilton-medical.com/C3

1 Ely EW, Baker AM, Dunagan DP, Burke HL, Smith AC, Kelly PT, Johnson MM, Browder RW, Bowton DL, Haponik EF. N Engl J Med. 1996 Dec 19;335(25):1864-9.

2 Kirakli C, Ozkan. Eur Respir J. 2011 Oct;38(4):774-80. 3 Chen CW, Huang YC. Respir Care. 2011 Jul;56(7):976-83.4 Cassina T, Chioléro R, Mauri R, Revelly JP. J Cardiothorac Vasc Anesth. 2003

Oct;17(5):571-5.

Intelligent Ventilation with ASV means fewer days on the ventilator and the use of less-invasive ventilation modes. As a result, clinicians can spend more time with their patients and ensure shorter stays in the ICU.The HAMILTON-C3 lets you optimize clinical resources and skills while reducing cost of ownership and management overhead. Most importantly, it can help reduce the patient’s time on the ventilator.

Know when to take the patient off the ventilatorThe Ventilation Cockpit’s Vent Status panel provides intuitive visualization of the most important parameters and settings related to patient-ventilator dependency. This innovation helps you decide when to take the patient off the ventilator. Studies have shown that notifying caregivers about the pa-tient’s recovery from respiratory failure can signifi cantly re-duce the duration and total cost of ventilation.1

Start weaning at intubationASV, the closed-loop ventilation system, automatically ASV, the closed-loop ventilation system, automatically ASV promotes free breathing for patients in all ventilation modes and phases. It encourages spontaneous activity right from the start of ventilation and promotes weaning from fi rst deployment. Studies show the results: shorter ventilation times (see graph on the previous page).2,3, 4

At the bedside or during transport: benefi t from a double-duty solutionThe HAMILTON-C3’s compact design and independence from external power and air supplies allow for maximum mobility external power and air supplies allow for maximum mobility external power and air supplies allow for maximum mobility throughout the hospital.throughout the hospital.throughout the hospital.

Effi ciency through innovation

Ergonomic and intuitive humidificationWith the HAMILTON-H900 humi-difi er, HAMILTON MEDICAL provides the optimal solution for condition-ing patient’s breathing air. The HAMILTON-H900 provides you with single-handed disposable replace-ment and wall heated smoothbore circuits to effectively prevent rainout.

How to know when to take the patient off the ventilator?The Vent Status panel gives you a visual re-presen tation of 6 parameters related to patient-ventilator dependency, grouped into:– oxygenation– CO2 elimination– patient activity

Since the panel is user-confi gurable, it helps you enforce your ICU’s weaning protocol.

Low dependency – consider Low dependency – consider taking the patient off the ventilator.

Highly dependent patientHighly dependent patient

www.hamilton-medical.com/C3

In addition to its unique features, the HAMILTON-C3 with ASVincludes everything you expect from a state-of-the-art venti-lation solution, including:– a choice of manually and/or fully controlled modes for

invasive and non-invasive ventilation– an extensive monitoring package– the ability to ventilate adult, pediatric, and neonatal

patients

Available Options:– Volumetric (Mainstream) CO2

– Sidestream CO2

– NeoNIV (nasal CPAP)– TRC– DuoPAP/APRV– Non invasive ventilation

For a complete overview of all features, functions, simulation software and latest news, please refer to:www.hamilton-medical.com/C3

A comprehensive ventilator

Configurable Ventilation CockpitThe Ventilation Cockpit lets you confi gure your patient’s moni-tored data the way you want. You can choose from various layouts to display a combination of Intel-ligent Panels, including Dynamic Lung, Vent Status, and ASV target graphics, plus traditional wave-forms.

IntelliTrigWith the innovative IntelliTrig technology, the HAMILTON-C3 auto matically responds to varying leaks and adapts sensitivity thresh-olds for optimal response to the patient’s breathing pattern.

ASV Adaptive Support Ventilation (ASV) is a closed loop mode based on a breath-by-breath “assess, optimize and achieve” concept: 1. Assess the patient’s lung mechanics. 2. Optimize the tidal volume/respiratory frequency com-

bination based on lung mechanics. 3. Achieve optimum tidal volume/ respiratory frequency

by automatically adjusting mandatory rate and inspiratory pressure applying lung-protective strategy rules.

IntelliSync Makes ventilation easier and more comfortable for the patient by au-tomatically switching between con-trolled and spontaneous ventilation.

Flexible device configurationYou can con fi gure the device mounting ways to adapt the HAMILTON-C3 to your environment:– on a standard trolley, with optional humidifi er and

O2 cylinder mounts– with an adaptable plate to any support you like

12.112.1-inch high resolution wide touchscreen and -inch high resolution wide touchscreen and single-knob operationsingle-knob operationsingle-knob operationsingle-knob operationYou can operate the You can operate the HAMILTON-C3HAMILTON-C3 via the touchscreen or by using a single knob. Hard keys give direct access to the by using a single knob. Hard keys give direct access to the by using a single knob. Hard keys give direct access to the most important functions.most important functions.

360° alarm lamp360° alarm lampYou can immediately identify an alarming ventilator by You can immediately identify an alarming ventilator by You can immediately identify an alarming ventilator by the alarm lamp at the top – even when you are at a dis-the alarm lamp at the top – even when you are at a dis-the alarm lamp at the top – even when you are at a dis-tance or when several devices are operated in the same tance or when several devices are operated in the same tance or when several devices are operated in the same tance or when several devices are operated in the same tance or when several devices are operated in the same tance or when several devices are operated in the same room.room.

Serial interface for Serial interface for PDMS or patient monitoror patient monitorThe serial RS-232 interface provides a port connecting The serial RS-232 interface provides a port connecting The serial RS-232 interface provides a port connecting hospital monitors and Patient Data Management Systems hospital monitors and Patient Data Management Systems hospital monitors and Patient Data Management Systems (PDMS).(PDMS).

Extended battery backup optionExtended battery backup optionExtended battery backup optionExtended battery backup optionExtended battery backup optionExtended battery backup optionWith the extended battery option, your With the extended battery option, your With the extended battery option, your HAMILTON-C3can run indefi nitely on hot-swappable batteries. With can run indefi nitely on hot-swappable batteries. With can run indefi nitely on hot-swappable batteries. With 2 fully charged batteries independent operation of 2 fully charged batteries independent operation of 2 fully charged batteries independent operation of 6.56.5 hours can be achieved.

High-performance, ultra-quiet turbineHigh-performance, ultra-quiet turbineHigh-performance, ultra-quiet turbineThe turbine can deliver a fl ow of up to The turbine can deliver a fl ow of up to The turbine can deliver a fl ow of up to 240 l/min. The fl ow is precisely dosed by the inspiratory valve. Patented fl ow is precisely dosed by the inspiratory valve. Patented fl ow is precisely dosed by the inspiratory valve. Patented noise reduction allows you to use the noise reduction allows you to use the noise reduction allows you to use the HAMILTON-C3 even in an ultra-quiet environment.in an ultra-quiet environment.

For further information about the HAMILTON-C3 please contact:

6894

73/0

1 Sp

ecifi

cat

ion

s ar

e su

bje

ct t

o c

han

ge

wit

ho

ut

no

tice

. IN

TELL

iVEN

T, A

SV a

nd

Du

oPA

P ar

e tr

adem

arks

of

HA

MIL

TON

MED

ICA

L.

©20

12 H

AM

ILTO

N M

EDIC

AL

AG

. All

rig

hts

res

erve

d. P

rin

ted

in S

wit

zerl

and

. Sp

ecia

l th

anks

to

th

e Sp

ital

Zo

llike

rber

g S

wit

zerl

and

.

HAMILTON MEDICAL AGVia Crusch 8CH-7402 Bonaduz Switzerland

(+41) 81 660 60 10 (+41) 81 660 60 20

www.hamilton-medical.com